Subretinal fluid in a patient undergoing cancer therapy: recognising MEK-associated retinopathy
29 October 2026
Autumn 2026
Matthew Chan FCOptom, Senior Lecturer and specialist optometrist at Bristol Eye Hospital and independent practice. Senior lecturer at Cardiff University, leading The College of Optometrists’ accredited Medical Retina Higher Certificate programme.
This case highlights mitogen-activated protein kinase (MEK)-associated retinopathy (MEKAR) presenting with bilateral multifocal subretinal fluid (SRF), initially suspected to represent central serous chorioretinopathy (CSCR). It emphasises the importance of a structured systemic history, recognising drug-induced retinal disease, and collaborative working with oncology in patients receiving targeted cancer therapy.
Presentation
A 60-year-old Caucasian male presented to his optometrist with a new central grey scotoma. VAs were 6/6 in both eyes, and he was urgently referred to the hospital eye service with suspected CSCR. He had recently begun systemic cancer therapy.
Medical/ocular history
Ocular history: Myopia only; last routine eye examination within the previous year.
Medical history: Metastatic non-small cell lung adenocarcinoma; metastatic prostate cancer; transitional cell carcinoma of the bladder (under surveillance); pre-diabetes; hypercholesterolaemia.
Medication: Dabrafenib and trametinib (MEK inhibitor), commenced one month before presentation.
Not already a member of the College?
Start enjoying the benefits of College membership today. Take a look at what the College can offer you and view our membership categories and rates.
Related further reading
The College of Optometrists has responded to the GOC consultation on the proposed updated statement on testing of sight and proposed supervision and delegation standards.
The GOC’s findings indicate strong patient satisfaction with eye care services but identifies that registrants have concerns that commercial pressures could potentially impact their ability to deliver the best possible care to patients, as well as affecting their wellbeing.
This Halloween we're urging the public to think about their eye health.